Wednesday, September 23, 2015

Back on February 6, 2015, the Supreme Court of Canada
announced its ruling on Carter v. Canada as shown on this document:

The Supreme Court
unanimously ruled that people with both grievous and irremediable medical
conditions should have the right to ask a doctor to help them die as shown in
these key paragraphs:

"Insofar as they
prohibit physician-assisted dying for competent adults who seek such assistance
as a result of a grievous and irremediable medical condition that causes
enduring and intolerable suffering, ss. 241(b) and 14 of the Criminal Code deprive these adults
of their right to life, liberty and security of the person under s. 7 of the Charter. The right to life is engaged
where the law or state action imposes death or an increased risk of death on a
person, either directly or indirectly. Here, the prohibition deprives some
individuals of life, as it has the effect of forcing some individuals to take
their own lives prematurely, for fear that they would be incapable of doing so
when they reached the point where suffering was intolerable. The rights to
liberty and security of the person, which deal with concerns about autonomy and
quality of life, are also engaged. An individual’s response to a grievous and
irremediable medical condition is a matter critical to their dignity and
autonomy. The prohibition denies people in this situation the right to make
decisions concerning their bodily integrity and medical care and thus trenches
on their liberty. And by leaving them to endure intolerable suffering, it
impinges on their security of the person.

The prohibition on
physician-assisted dying infringes the right to life, liberty and security of
the person in a manner that is not in accordance with the principles of
fundamental justice. The object of the prohibition is not, broadly, to preserve
life whatever the circumstances, but more specifically to protect vulnerable
persons from being induced to commit suicide at a time of weakness. Since a
total ban on assisted suicide clearly helps achieve this object, individuals’
rights are not deprived arbitrarily. However, the prohibition catches people
outside the class of protected persons. It follows that the limitation on
their rights is in at least some cases not connected to the objective and that
the prohibition is thus overbroad. It is unnecessary to decide whether the
prohibition also violates the principle against gross disproportionality."
(my
bold)

While I realize that this
subject is as divisive as abortion, it is a subject that is of great interest
to me, particularly since, in recent years, I have lost both of my parents, one
who endured extreme pain from untreatable multiple cancers and another who lost
all dignity as a result of dementia.

At the time of the
decision, the Supreme Court gave provincial and federal governments 12 months to
craft new legislation to deal with their ruling; since then, nearly eight months have
passed and there has been a notable lack of progress from Ottawa on this issue.
The Harper government finds itself between a rock and a hard place
because the religious base of the Conservative Party of Canada has a very clear
opinion on the issue.

Back in 2012, the Quebec National Assembly's Select Committee on Dying with
Dignity released a report that examined in great detail what
society's answer is to the suffering that some people experience at the end of
life or during a degenerative disease. Quebec was willing to admit that
the debate on euthanasia and assisted suicide was something that could no
longer be avoided and that the National Assembly and its elected Members had a duty to deal with
this issue as stated here:

"It is also clear
that the National Assembly must also turn its attention to this issue. MNAs
have a responsibility to focus on major societal debates that are ongoing in
the population. It is in fact one of their crucial functions as elected
representatives. We must also ensure that these discussions are conducted
responsibly and under ideal conditions in order to foster calm, respectful
debate."

Sadly, this does not
appear to be the case with the federal government. Leadership on this issue is sadly missing.

After having gone through
the issue of dying with dignity with my own parents, here is a key paragraph in the report:

"Getting
society to accept that death, like birth, is a natural phase of life is no
small task. However, only when we succeed in this regard will palliative care
become a genuine part of the continuum of care."

From my
personal and very recent experience, a significant part of palliative care is the use
of sedation to induce sleep and continuously relieve the patient's awareness
that they are suffering, a process that some regard as euthanasia in
disguise. This is particularly important where the use of pain
medications like morphine no longer reduce pain and discomfort. One of the
problems occurring from palliative sedation is the cessation of
nutrition and hydration. In my own case, I can recall having feelings
that my loved one was being starved to death, however, many physicians feel
that the combination of palliative sedation and withdrawal of
nutrition hasten death for the sufferer.

Interestingly, in January
2015, Canada Revenue Agency annulled the charitable status of Dying With Dignity Canada effective on February 15, 2015. Dying
With Dignity Canada was founded in 1982 to promote choice and
dignity at the end of life, educating Canadians about patient rights, advance
care planning, providing one-on-one support to individuals who are dying and
want to do so on their own terms. CRA determined that "DWD
Canada does not conduct any activities that advance education in the charitable
sense" and that they are primarily "political". In case
you missed it, Dying with Dignity was an intervener on the Carter v. Canada
case. Why did CRA annul Dying With Dignity Canada's charitable status?
They claimed that the organization was registered in error as a charity way back in
1982. It just took CRA 23 years to figure that out and annul their status. I think that this gives us a sense of where the Harper government stood on the issue.

From this, I think that
we have some idea of why the Harper government has pretty much chosen
to ignore this rather discomforting subject, preferring to deal with it
after the October 2015 federal election, just in case their stance on this
issue alienates their base. As well, any response to the Supreme Court
decision will require co-operation between the federal government and the
provincial governments who each have their own provincial colleges of
physicians, a prospect that must make Mr. Harper rather uncomfortable since he
has shown little interest in federal - provincial policy discussions of any
type and around any issue. In response to this very important and looming
issue which is of particular importance as Canada's population ages, voters need to ensure that they hold candidates from all political
parties accountable for at least taking a firm stand on the issue, particularly since there will be less than four months to craft legislation after the October election date.

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About Me

I have been an avid follower of the world's political and economic scene since the great gold rush of 1979 - 1980 when it seemed that the world's economic system was on the verge of collapse. I am most concerned about the mounting level of government debt and the lack of political will to solve the problem. Actions need to be taken sooner rather than later when demographic issues will make solutions far more difficult. As a geoscientist, I am also concerned about the world's energy future; as we reach peak cheap oil, we need to find viable long-term solutions to what will ultimately become a supply-demand imbalance.